Rivera's June 2008 lawsuit, which also names Drs. Dawn M. Thornton and Virendra K. Saxena, who worked at Shady Grove Hospital at the time, Montgomery Emergency Physicians LLC in Rockville and Critical Care Consultants PC of Silver Spring, claims the defendants failed to properly diagnose and treat her for a blockage in her ureter caused by kidney stones.

Rivera, 28, now relies on the aid of a prosthetic leg and shoe insert to walk. Before her medical problems, she worked two jobs  one as a maid and another as a McDonald's cashier. Now, she no longer is able to work as either.

Still, Rivera is grateful following the Aug. 9 award from a Montgomery County Circuit Court jury, Malarkey said.

Malarkey has advised Rivera not to speak publicly about the case at this time.

Although the jury awarded Rivera $2.35 million, Maryland has caps on non-economic damages, such as pain and suffering. That likely will diminish the amount Rivera receives, said Wayne M. Willoughby, a Baltimore malpractice attorney and member of the Maryland Association for Justice, an organization representing trial attorneys and their interests. The cap for medical injuries at the time of Rivera's treatment at Shady Grove Adventist in 2006 was $650,000.

"I'm certain with the type of injuries, the verdict will be significantly reduced," he said.

Rivera's interaction with Shady Grove Adventist began Aug. 1, 2006, when she went to the hospital and complained of pain in her abdomen that radiated to her groin. According to the lawsuit, doctors treated her with pain medication and intravenous fluids after diagnosing her with kidney stones and renal colic. She was discharged the same day.

Rivera returned to the emergency room by ambulance two days later and was admitted to the hospital after complaining of dizziness, severe abdominal pain and bloating; she also was showing signs of septic shock, according to the lawsuit. She was diagnosed with acute cholecystitis, or inflammation of the gall bladder.

Twelve hours after arriving at Shady Grove, a urology specialist operated on Rivera and discovered the septic shock was caused by a blockage of the ureter caused by the kidney stones diagnosed Aug. 1, 2006, the lawsuit states.

During her recovery period, Rivera was afflicted with gangrene, leading to the amputation of her left leg below the knee and partial amputation of her right foot, according to the lawsuit. She eventually lost the tips of her fingers from autoamputation, or the spontaneous detachment of an appendage from the body, the lawsuit states.

Malarkey was pleased with the outcome of the case.

"I think the jury did the right thing." Malarkey said. "They heard the evidence and made the right decision."

Jennifer Plaia, spokeswoman for Shady Grove Adventist Hospital, provided a statement to The Gazette by e-mail.

"We are saddened for this woman and her unfortunate circumstances," she wrote. "Out of respect for her privacy we are limiting our comments on her medical condition and specific care in 2006. Our internal review of this four-year-old case found that in light of the complexity of the patient's illness, our physicians delivered appropriate care."

Over the past decade, Shady Grove Adventist Hospital has been praised and criticized in its handling of patient care. In 1999, the hospital was investigated on the state and federal level for poor care, leading the Joint Commission on Accreditation of Healthcare Organizations to downgrade the hospital's accreditation rating.

In 2007, Shady Grove Adventist made a turnaround, earning a place on the 100 Top Hospitals Performance Improvement Leaders for 2007 by Thomson Reuters, a company that compiles data and is owned by Reuters news agency.